title: Comparison of primary jejunostomy tubes versus gastrojejunostomy tubes for percutaneous enteral nutrition.
abstract: OBJECTIVE
  To evaluate technical success and long-term outcomes of percutaneous primary jejunostomy tubes for postpyloric enteral feeding compared with percutaneous gastrojejunostomy (GJ) tubes.
  
  
  METHODS
  Over a 25-month interval, 41 consecutive patients (26 male; mean age, 55.9 y) underwent attempted fluoroscopy-guided direct percutaneous jejunostomy tube insertion. Insertions at previous jejunostomy tube sites were excluded. The comparison group consisted of all primary GJ tube insertions performed over a 12-month interval concomitant with the jejunostomy tube interval (N = 169; 105 male; mean age, 59.4 y). Procedural, radiologic, and clinical data were retrospectively reviewed. Intervention rates were expressed as events per 100 catheter-days.
  
  
  RESULTS
  The technical success rate for percutaneous jejunostomy tube insertion was 96%, versus 93% for GJ tubes (P = .47). Mean fluoroscopy times were similar for jejunostomy and GJ tubes (9.8 vs 10.0 min, respectively; P value not significant). Jejunostomy tubes exhibited a lower rate of catheter dysfunction than GJ tubes, with catheter exchange rates of 0.24 versus 0.93, respectively, per 100 catheter-days (P = .045). GJ tube tip retraction into the stomach occurred in 9.5% of cases, at a rate of 0.21 per 100 catheter-days. Intervention rates related to leakage were 0.19 and 0.03 for jejunostomy and GJ tubes, respectively (P < .01). Jejunostomy and GJ tubes exhibited similar rates of catheter exchange for occlusion and replacement as a result of inadvertent removal. No major complications were encountered in either group.
  
  
  CONCLUSIONS
  Percutaneous insertion of primary jejunostomy tubes demonstrated technical success and complication rates similar to those of GJ tubes. Jejunostomy tubes exhibited a lower dysfunction rate but a higher leakage rate compared with GJ tubes.
authors.affiliation: Division of Vascular and Interventional Radiology, Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710. Electronic address: charles.kim@dm.duke.edu.
authors.forename: Charles Y
authors.initials: CY
authors.lastname: Kim
authors.forename: Bjorn I
authors.initials: BI
authors.lastname: Engstrom
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Horvath
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Lungren
authors.forename: Paul V
authors.initials: PV
authors.lastname: Suhocki
authors.forename: Tony P
authors.initials: TP
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004750:Enteral Nutrition / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D005471:Fluoroscopy; D015390:Gastric Bypass / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D007582:Jejunostomy / Q000009:adverse effects / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: GJ; gastrojejunostomy